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二十碳五烯酸乙酯(二十碳五烯酸乙酯):对代谢综合征患者高敏C反应蛋白和血脂参数的影响。

Icosapent Ethyl (Eicosapentaenoic Acid Ethyl Ester): Effects Upon High-Sensitivity C-Reactive Protein and Lipid Parameters in Patients With Metabolic Syndrome.

作者信息

Bays Harold E, Ballantyne Christie M, Braeckman Rene A, Stirtan William G, Doyle Ralph T, Philip Sephy, Soni Paresh N, Juliano Rebecca A

机构信息

1 Louisville Metabolic and Atherosclerosis Research Center , Louisville, Kentucky.

2 Baylor College of Medicine and the Methodist DeBakey Heart and Vascular Center , Houston, Texas.

出版信息

Metab Syndr Relat Disord. 2015 Aug;13(6):239-47. doi: 10.1089/met.2014.0137. Epub 2015 Apr 20.

Abstract

BACKGROUND

The aim of this analysis was to examine the effects of icosapent ethyl (eicosapentaenoic acid ethyl ester, IPE) on high-sensitivity C-reactive protein (hsCRP) and lipid parameters in patients with metabolic syndrome, with and without stable statin therapy.

METHODS

This post hoc exploratory analysis evaluated patients with metabolic syndrome treated with IPE 4 grams/day, IPE 2 grams/day, or placebo in phase 3, randomized, placebo-controlled studies entitled: MARINE [triglyceride (TG) levels ≥500 and ≤2000 mg/dL] and ANCHOR [TG levels ≥200 and <500 mg/dL, despite low-density lipoprotein cholesterol (LDL-C) control with stable statin therapy].

RESULTS

Compared with placebo in patients with metabolic syndrome in MARINE (n=204) and ANCHOR (n=645), at the approved dose of 4 grams/day, IPE significantly lowered hsCRP levels 40.0% (P=0.0007) in MARINE and 23.0% (P=0.0003) in ANCHOR. Compared with placebo in MARINE, which included patients with and without statin therapy, IPE 4 grams/day significantly reduced hsCRP levels 78.0% in statin-treated patients (P=0.0035, n=16). Compared with placebo in MARINE, IPE 4 grams/day significantly reduced TG levels (35.0%; P<0.0001), non-high-density lipoprotein cholesterol (non-HDL-C; 19.9%; P<0.0001), and apolipoprotein B levels (ApoB) (9.1%; P=0.0015) without raising LDL-C levels. Compared with placebo in ANCHOR, IPE 4 grams/day significantly reduced TG (21.7%; P<0.0001), non-HDL-C (13.5%; P<0.0001), ApoB (8.8%; P<0.0001), LDL-C (5.2%; P=0.0236), and HDL-C levels (4.0%; P=0.0053).

CONCLUSIONS

Compared with placebo, IPE 4 grams/day significantly lowered hsCRP levels and improved lipids without raising LDL-C levels in patients with metabolic syndrome and high (≥200 and <500 mg/dL) or very high (≥500 and ≤2000 mg/dL) TG levels, with or without stable statin therapy.

摘要

背景

本分析旨在研究二十碳五烯酸乙酯(icosapent ethyl,IPE,即二十碳五烯酸乙酯)对代谢综合征患者高敏C反应蛋白(hsCRP)及血脂参数的影响,这些患者接受或未接受稳定的他汀类药物治疗。

方法

这项事后探索性分析评估了在两项3期随机、安慰剂对照研究中接受治疗的代谢综合征患者,这两项研究分别为MARINE [甘油三酯(TG)水平≥500且≤2000mg/dL] 和ANCHOR [尽管接受稳定的他汀类药物治疗使低密度脂蛋白胆固醇(LDL-C)得到控制,但TG水平≥200且<500mg/dL]。患者分别接受每天4克IPE、每天2克IPE或安慰剂治疗。

结果

在MARINE(n = 204)和ANCHOR(n = 645)中,与代谢综合征患者的安慰剂相比,在批准剂量每天4克的情况下,IPE在MARINE中使hsCRP水平显著降低40.0%(P = 0.0007),在ANCHOR中降低23.0%(P = 0.0003)。在MARINE中,与安慰剂相比,包括接受和未接受他汀类药物治疗的患者,每天4克IPE使接受他汀类药物治疗的患者hsCRP水平显著降低78.0%(P = 0.0035,n = 16)。在MARINE中,与安慰剂相比,每天4克IPE显著降低TG水平(35.0%;P < 0.0001)、非高密度脂蛋白胆固醇(non-HDL-C;19.9%;P < 0.0001)和载脂蛋白B水平(ApoB)(9.1%;P = 0.0015),而未升高LDL-C水平。在ANCHOR中,与安慰剂相比,每天4克IPE显著降低TG(21.7%;P < 0.0001)、non-HDL-C(13.5%;P < 0.0001)、ApoB(8.8%;P < 0.0001)、LDL-C(5.2%;P = 0.0236)和高密度脂蛋白胆固醇(HDL-C)水平(4.0%;P = 0.0053)。

结论

与安慰剂相比,对于代谢综合征且TG水平高(≥200且<500mg/dL)或非常高(≥500且≤2000mg/dL)的患者,无论是否接受稳定的他汀类药物治疗,每天4克IPE均可显著降低hsCRP水平并改善血脂,且不升高LDL-C水平。

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